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When your heart can't keep its rhythm

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August 23rd, 2010
health0910_heart_wide
health0910_heart_wide
Atrial fibrillation (a-tre-al fi-bri-LA-shun), or AF, is a problem with the heart s rhythm. It s a fairly common condition in people over the age of 65, says Philip Taylor, M.D., medical director atMaris Grove. ' An estimated 2.2 million Americans are living with AF. AF is caused by a disorder in the heart s electrical system. Rapid, disorganized electrical signals in the heart s two upper chambers, called the atria, cause them to rapidly and irregularly quiver instead of beating with regular contractions. This electrical disturbance in the atria causes the ventricles [the heart s two lower chambers] to beat irregularly as well, says Daniel Brauner, M.D., a geriatrician and associate professor of medicine at the University of Chicago. If one s heart beats too rapidly, then it won t pump blood very efficiently. Underlying causes of AF can vary. Sometimes AF may be related to chronic heart disease, hyperthyroidism, or chronic lung disease. Sometimes we don t know the cause it may be related to aging changes in heart cells, Taylor says.

AF: a ' dangerous condition

People who have AF may not have any symptoms and not even know they have the condition. Some people, however, have symptoms like palpitations, chest pain, shortness of breath, weakness, dizziness, fainting, fatigue, or confusion. The biggest risk of having AF is the potential for a stroke, Taylor says. Blood clots form because blood is pooling in the atria these clots can lead to strokes, Brauner explains. Having AF also increases your risk of heart attack or heart failure. People who have AF can live normal, active lives. For some people, treatment can cure AF and return their heartbeat to a normal rhythm. For people who have permanent AF, medicines or procedures to restore normal rhythm can successfully control symptoms and may prevent complications.

What to know about anticoagulation therapy

The medicines prescribed for AF are typically anticoagulants [sometimes called blood thinners ], meant to keep your blood from clotting too quickly, Taylor says. The most common is warfarin [Coumadin]. If you are taking warfarin, you need to have blood drawn regularly to ensure that your clotting factors are operating within a particular range, Brauner says. Your medication dosage may change from month to month or even week to week, depending on your lab results, Brauner says. Always confirm your medication dosage with your doctor. Call to find out lab results if you don t hear from your doctor within 24 hours of having your blood drawn. Tell your doctor about other medications, especially over-the-counter drugs or supplements. Some of these can affect your blood s ability to clot. So can certain foods. Many foods that contain vitamin K can interfere with your clotting status. You can eat them, but you need to keep up a steady intake in other words, don t eat a lot one day and then a little the next, advises Brauner. Vitamin K is found in many green vegetables like spinach, turnip greens, collard greens, broccoli, and Brussels sprouts. Some fruits like kiwi, blackberries, and blueberries also contain vitamin K. When you are taking anticoagulants, you need to be careful of injuries, even minor ones. It is common to see small areas of bleeding under the skin with even minor trauma in people taking warfarin, Brauner says. Seek medical help quickly if you have any bleeding that doesn t stop in a short time even a nosebleed. Minor bleeding could become an emergency, he adds. Keep your appointments for your blood work and adhere exactly to your dose of medication, Taylor adds. Always tell all of your health care providers that you are taking anticoagulants.

Be safe when taking anticoagulants

To prevent injury in your home: Be very careful using knives and scissors. Use an electric razor. Use a soft toothbrush. Use waxed dental floss. Do not use toothpicks. Wear shoes or non-skid slippers in the house. Be careful when you trim your toenails. Do not trim corns or calluses yourself.

To prevent injury outdoors: Always wear shoes. Wear gloves when using sharp tools. Avoid activities and sports that can easily hurt you. Wear gardening gloves when doing yard work.

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